Browsing by Author "Olley, B. O"
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Item The effects of psychological inoculation on cognitive barriers against condom use in women with HIV: A controlled pilot study(Ife Centre for Psychological Studies, 2011) Olley, B. O; Abass, M.; Gidron, Y.Past studies have shown that in attempts to prevent HIV, health education yields little change in condom use. The reason may be that education fails to target barriers for changing behaviour. The present controlled pilot study tested whether psychological inoculation (PI) reduces such barriers for using male condoms. Twenty-two Nigerian women with HIV were randomly assigned to receive PI or health education (control). In the PI condition, women learned to refute sentences reflecting barriers against condom use, while controls learned how to use condoms and the consequences of their non-use. Barriers for condom use, self-efficacy to negotiate condom use with partners and actual condom use were self-reported before and one week after interventions. Results revealed that only in the PI group were there statistically significant increases in condom use negotiating self-efficacy and reductions in barriers concerning motivation, sexual satisfaction and partners. Controls reported no statistically significant changes. However, actual reported condom use was unchanged in both groups. Thus, it is feasible to conduct PI interventions in an African sample of HIV patients. Furthermore, PI can reduce cognitive barriers for condom use, while health education yields little changes in such outcomes over time. If replicated in larger samples with longer follow-ups, these findings could eventually have implications for HIV prevention in several world regions.Item Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa(2005-07) Olley, B. O; Zeier, M. D.; Seedat, S.; Stein, D. J.This study examined the prevalence of and factors associated with post-traumatic stress disorder in recently diagnosed HIV/AIDS patients in South Africa. One hundred and forty-nine (44 male, 105 female) recently diagnosed HIV/AIDS patients (mean duration since diagnosis= 5.8 months, = 4.1) were evaluated. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI), the Carver Brief COPE coping scale and the Sheehan Disability Scale. In addition, previous exposures to trauma and past risk behaviours were assessed. Twenty-two patients (14.8%) met criteria for PTSD. Current psychiatric conditions more likely to be associated with PTSD included major depressive disorder (29% in PTSD patients versus 7% in non-PTSD patients, p= 0.004), suicidality (54% versus 11%, p= 0.001) and social anxiety disorder (40% versus 13%, p= 0.04). Further patients with PTSD reported significantly more work impairment and demonstrated a trend towards higher usage of alcohol as a means of coping. Discriminant function analysis indicated that female gender and a history of sexual violation in the past year were significantly associated with a diagnosis of PTSD. Patients whose PTSD was a direct result of an HIV/AIDS diagnosis (8/22) did not differ from other patients with PTSD on demographic or clinical features. In the South African context, PTSD is not an uncommon disorder in patients with HIV/AIDS. In some cases, PTSD is secondary to the diagnosis of HIV/AIDS but in most cases it is seen after other traumas, with sexual violation and intimate partner violence in women being particularly important.Item Predictors of major depression in recently diagnosed patients with HIV/AIDS in South Africa(Mary Ann Liebert, Inc., 2004) Olley, B. O; Seedat, S.; Nei, D. G.; Stein, D. J.There is increasing evidence that major depression impacts the course of HIV infection, yet few studies have explored demographic and clinical predictors of depression in people who with HIV/AIDS. This study investigated predictors of depression (e.g., demographic and clinical variables, negative life events, and coping response) among outpatients with recently diagnosed HIV/AIDS patients in South Africa. One hundred forty-nine recently diagnosed HIV/AIDS patients (44 males and 105 females; mean time since diagnosis= 5.8, standard deviation [SD] 4.1) were evaluated. Subjects were assessed using the Mini International Neuropsychiatric Interview (MINI), the Carver Brief COPE coping scale, and the Sheehan Disability Scale. In addition, previous exposures to trauma and past risk behaviors were assessed. Three variables: gender (odd ratio [OR]= 1.23; 95% confidence interval [CI] 1.56, 1.93), impact of negative life events (OR= 1.13; CI, 1.03, 1.23), and disability (OR= 1.51, CI, 1.28, 1.80) predicted current major depression. It is well known from non-HIV populations that female gender and increased negative life events predict depression. These data also emphasize the importance of these links in HIV.Item Psycho-educational therapy among Nigerian adult patients with epilepsy: a controlled outcome study(Elsevier, 2001) Olley, B. O; Osinowo, H. O.; Brieger, W. R.Psychological interventions in relation to epilepsy are worthy of empirical investigation since there is broad agreement that the psycho-social problems of epilepsy are often more disabling than the seizure attacks. The present study using a controlled outcome design evaluated the efficacy of a 2-day psycho-educational program among patients with epilepsy in Nigeria. The psycho-educational program is the consequence of a two-stage study design, which set out to identify and evaluate psycho-social factors that determine interictal psychopathology in people with epilepsy. Thirty out-patients matched according to seizure type and frequency of seizures were randomly assigned to treatment (n515) or waiting-list control (n515) groups. The major outcome measures used were knowledge about illness schedule, the Becks depression inventory and the Crown–Crisp experiential index. Significant differences between the two groups were found on the three major scales used. The treatment group by within-group analyses, showed a substantial significant decrease in level of depression, a significant increase in the knowledge about epilepsy as well as a significant decrease in all measures of neurotic disorders except for hysterical sub-scale.Item Psychopathology and coping in recently diagnosed HIV/AIDS patients- the role of gender(2003-12) Olley, B. O; Gxamza, F.; Seedat, S.; Theron, H.; Taljaard, J.; Reid, E.; Reuter, H.; Stein, D. J.Although there is growing literature on the psychological responses to and the psychopathology associated with HIV/AIDS, few investigations have focused on the role of gender. This study compared psychiatric morbidity, coping responses, and disability in male and female outpatients recently diagnosed with HIV/AIDS. Method. One hundred and forty-nine patients (44 male, 105 female) with HIV/AIDS (mean ± standard deviation (SD) months since diagnosis 5.8 ± 4.1) attending an infectious diseases clinic at Tygerberg Hospital, Cape Town, were evaluated. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI), the Carver Brief COPE, and the Sheehan Disability Scale. In addition, negative life events and risk behaviours were evaluated. Results. Fifty-six per cent of patients were diagnosed with a psychiatric disorder, most commonly major depression (34.9%), dysthymic disorder (21.5%), post-traumatic stress disorder (14.8%), and alcohol dependence (10.1 %). There were no significant gender differences in the prevalence of mood disorders in the sample. Men, however, were more likely than women to meet diagnostic criteria for alcohol abuse or dependence, and to engage in certain risky sexual behaviours. Women were more likely to suffer from post-traumatic stress disorder, and to use coping strategies of planning and religion to deal with the illness. There were no significant gender differences in disability. Conclusion. Psychiatric disorders are common in recently diagnosed HIV/AIDS patients in South Africa. Clinicians should be aware of the high prevalence of mood disorders in both men and women, and of gender-different responses such as increased alcohol and substance use and more risky sexual behaviour in men.Item A qualitative study of the feasibility and community perception on the effectiveness of artemether-lumefantrine use in the context of home management of malaria in south-west Nigeria(Elsevier Ltd., 2008) Ajayi, I. O.; Falade, C. O.; Olley, B. O; Yusuf, B.; Gbotosho, S.; Iyiola, T.; Olaniyan, O.; Happi, C.; Munguti, KBackground: In Nigeria ACT use at the community level has not been evaluated and the use of antimalarial drugs (commonly chloroquine (CQ)) at home has been shown to be largely incorrect. The treatment regimen of ACT is however more complicated than that of CQ. There is thus a need to determine the feasibility of using ACT at the home level and determine community perception on its use. Methods: A before and after qualitative study using key informant interviews (KII) and focus group discussions (FGDs) was conducted in selected villages in Ona-Ara local government area. At baseline, 14 FGDs and 14 KIIs were conducted. Thereafter, community medicine distributors (CMDs) were trained in each village to dispense artemeter-lumenfantrine (AL) to febrile children aged 6–59 months presumed to have uncomplicated malaria. After one year of drug distribution, nine KIIs and 10 FGDs were conducted. Participants and key informants were mothers and fathers with children under five years, traditional heads of communities, opinion leaders and health workers. Results: None of the participants have heard of AL prior to study. Participants were favourably disposed to introduction of AL into the community. Mothers/caregivers were said to have used AL in place of the orthodox drugs and herbs reported commonly used prior to study after commencement of AL distribution. The use of CMDs for drug distribution was acceptable to the participants and they were judged to be efficient as they were readily available, distributed correct dose of AL and mobilised the community effectively. AL was perceived to be very effective and no significant adverse event was reported. Major concerns to the sustainability of the program were the negative attitudes of health workers towards discharge of their duties, support to the CMDs and the need to provide CMDs incentives. In addition regular supply of drugs and adequate supervision of CMDs were advised. Conclusion: Our findings showed that the use of AL at home and community level is feasible with adequate training of community medicine distributors and caregivers. Community members perceived AL to be effective thus fostering acceptability. The negative attitudes of the health workers and issue of incentives to CMDs need to be addressed for successful scaling-up of ACT use at community level.Item Sexual coercion in young persons: exploring the experiences in Ibadan, Nigeria(emerald, 2004) Ajuwon, A. J; Olley, B. O; Akintola, O.; Akin-Jimoh, I.In-depth interviews with eight female victims of rape in Ibadan, Nigeria were used to explore the context in which the coercive incident occurred, the health-seeking behaviours that followed and the consequences of this experience in victims' lives. The mean age of the women was 17 years. In all cases, perpetrators of rape were persons with whom the women were acquainted. Rape occurred mainly in familiar and private settings. Rarely do victims communicate the incident to family or friends or report the incident to the enforcement authorities. The stigma associated with rape is a primary barrier to seeking care. Interventions are proposed to address these problems.